• Title/Summary/Keyword: 병원 의학

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Typical and Atypical Imaging Features of Malignant Lymphoma in the Abdomen and Mimicking Diseases (복부 악성 림프종의 영상 소견 및 비슷한 소견을 보일 수 있는 질병들)

  • Jong Eun Kim;So Hyun Park;Young Sup Shim;Sungjin Yoon
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1266-1289
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    • 2023
  • Malignant lymphoma typically presents with homogeneous enhancement of enlarged lymph nodes without internal necrotic or cystic changes on multiphasic CT, which can be suspected without invasive diagnostic methods. However, some subtypes of malignant lymphoma show atypical imaging features, which makes diagnosis challenging for radiologists. Moreover, there are several lymphoma-mimicking diseases in current clinical practice, including leukemia, viral infections in immunocompromised patients, and primary or metastatic cancer. The ability of diagnostic processes to distinguish malignant lymphoma from mimicking diseases is necessary to establish effective management strategies for initial radiological examinations. Therefore, this study aimed to discuss the typical and atypical imaging features of malignant lymphoma as well as mimicking diseases and discuss important diagnostic clues that can help narrow down the differential diagnosis.

The Case of Toxicity Caused by Scopolia Japonica Ingestion Treated with Gamigamdu-Tang. (낭탕근(狼菪根) 중독 환자의 가미감두탕(加味甘豆湯) 투여 증례 1례)

  • Lee, Hye-Yoon;Cho, Su-In;Park, Hye-Lim;Cho, Min-Kyoung;Lee, In;Hong, Jin-Woo;Kwon, Jung-Nam
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.15 no.1
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    • pp.50-56
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    • 2014
  • The prevalence rate of plant poisoning is growing up gradually. However, it could be difficult to get proper treatment without detail medical history taking due to the diversity of poisonous plants and their various symptoms. Scopolia Japonica, which grows naturally in Korea, is reported to cause severe toxicity which could be lethal. A few therapeutic measures have been reported in Traditional Korean Medicine (TKM), but it has not been reported yet that those measures have been successfully proven in the clinical practice in modern times. This is a case report of toxicity caused by scopolia japonica ingestion. A 65years-old male patient with cognitive impairment, behavioral disorder, gait difficulty, dysarthria, dysphagia and abnormal pupil reflex recovered from those symptoms during taking Gamigamdu-tang and getting acupuncture. This study shows the clinical aspects of Scopolia Japonica toxicity and the possibility of TKM treatments as one of plant poisoning treatments.

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Expert Opinions and Recommendations for the Clinical Use of Quantitative Analysis Software for MRI-Based Brain Volumetry (뇌 자기공명영상 뇌용적 분석 소프트웨어의 임상적 적용에 대한 전문가 의견과 권고안)

  • Ji Young Lee;Ji Eun Park;Mi Sun Chung;Se Won Oh;Won-Jin Moon;Aging and Neurodegeneration Imaging (ANDI) Study Group, Korean Society of Neuroradiology (KSNR)
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1124-1139
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    • 2021
  • The objective assessment of atrophy and the measurement of brain volume is important in the early diagnosis of dementia and neurodegenerative diseases. Recently, several MR-based volumetry software have been developed. For their clinical application, several issues arise, including the standardization of image acquisition and their validation of software. Additionally, it is important to highlight the diagnostic performance of the volumetry software based on expert opinions. We instituted a task force within the Korean Society of Neuroradiology to develop guidelines for the clinical use of MR-based brain volumetry software. In this review, we introduce the commercially available software and compare their diagnostic performances. We suggest the need for a standard protocol for image acquisition, the validation of the software, and evaluations of the limitations of the software related to clinical practice. We present recommendations for the clinical applications of commercially available software for volumetry based on the expert opinions of the Korean Society of Neuroradiology.

Radiographic Analysis of Scoliosis Using Convolutional Neural Network in Clinical Practice (컨볼루션 신경망을 이용한 척추측만증의 방사선학적 분석의 임상 적용)

  • Ha Yun Oh;Tae Kun Kim;Yun Sun Choi;Mira Park;Ra Gyoung Yoon;Jin Kyung An
    • Journal of the Korean Society of Radiology
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    • v.85 no.5
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    • pp.926-936
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    • 2024
  • Purpose To assess the reliability and accuracy of an automated Cobb angle measurement (ACAM) using a convolutional neural network (CNN) for scoliosis evaluation and to compare measurement times. Materials and Methods ACAM was applied to spine radiographs in 411 patients suspected of scoliosis. Observer 1 (consensus of two musculoskeletal radiologists) and observer 2 (a radiology resident) measured Cobb angle (CA). CA measurements were categorized using observer 1's measurements as the reference standard. Inter-observer reliability and correlation were assessed using intraclass correlation coefficient (ICC) and Spearman's rank correlation coefficient, respectively. Accuracy and measurement time of ACAM and observers were evaluated. Results ACAM demonstrated excellent reliability and very high correlation with observer 1 (ICC = 0.976, Spearman's rank correlation = 0.948), with a mean CA difference of 1.1. Overall accuracy was high (88.2%), particularly in mild (92.2%) and moderate (96%) scoliosis. Accuracy was lower in spinal asymmetry (77.1%) and higher in severe scoliosis (95%), although the CA was lower compared to the observers. ACAM significantly reduced measurement time by nearly half compared to the observers (p < 0.001). Conclusion ACAM using CNN enhances CA measurement for assessing mild or moderate scoliosis, despite limitations in spinal asymmetry or severe scoliosis. Nonetheless, it substantially decreases measurement time.

Detecting Potassium Imbalance: Whole Blood vs. Serum (전혈과 혈청에서의 칼륨 이상소견 검사의 차이)

  • Cho, Young-Duck;Choi, Sung-Hyuk;Yoon, Young-Hoon;Park, Sang-Min;Kim, Jung-Youn;Lim, Chae-Seung
    • The Korean Journal of Blood Transfusion
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    • v.23 no.2
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    • pp.162-168
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    • 2012
  • Background: Potassium, the most common cation in the intracellular space, plays a critical role in our physiology. Potassium imbalance may cause life-threatening problems, ranging from general weakness to cardiac arrest due to ventricular fibrillation. For emergency physicians, detection of such derangement within a short period of time is of critical importance. In this study, we wanted to determine whether analysis of whole blood samples can be used as a screening tool for potassium imbalance by comparative analysis of whole blood and serum samples. Methods: Two samples were drawn from 227 patients. The whole blood sample was taken from the radial artery and contained in a commercially available arterial blood collection syringe with a lithium-heparin coating. The serum sample was contained in a commercially available vacuum bottle in a non-additive silicone coated tube and transported to the laboratory. The study population was divided into three groups, patients with normal whole blood potassium, patients with decreased whole blood potassium, and patients with elevated whole blood potassium. Potassium levels for each group were coupled with serum potassium levels and compared. Results: No significant difference in potassium values was observed between whole blood and serum samples (P<0.05). Strong associations were observed among the three groups (normal range, hypokalemia, and hyperkalemia group). Compared to the normal group (r=0.851), the hyperkalemia group showed a stronger association between variables (r=0.897), and the hypokalemia group showed a weaker association (r=0.760). Their correlation coefficients were highly significant (P<0.05). Conclusion: Our study illustrates that point-of-care testing using whole blood with whole blood can be a reliable screening tool when treating patients with suspicious potassium abnormality, especially in hyperkalemia patients.

The Relationship between Possibility of Bipolar Disorder and Suicidal Attempt in Emergency Room (자살시도로 응급실에 내원한 환자의 자살 위험성과 양극성 장애 가능성의 연관성)

  • Huh, Lyang;Kim, Kun Hyung;Chun, Jin Ho;Park, Young Min;Kim, Young Hoon;Lee, Bong Ju
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.2
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    • pp.107-113
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    • 2015
  • Objectives : The aim of this study was to investigate the factors including possibility of bipolar disorder that are related to intensity of suicidal idea. Methods : The study subjects consisted of 50 patients who did suicidal attempt and treated at the Inje University Haeundae Paik Hospital Emergency Room. All participants underwent psychiatric interview and underwent Columbia Suicide Severity Rating Scale(C-SSRS), Beck Depression Inventory(BDI), Korean Version of Mood Disorder Questionnaire(MDQ) and Bipolar Spectrum Diagnostic Scale(BSDS) to evaluate patient's suicide attempt, severity of depression and possibility of bipolar disorder. Results : Compared to non-high risk group, suicide high risk group showed significantly higher BDI(p<0.001) and intensity of ideation(IOI) in C-SSRS(p<0.001). Also intensity of ideation(IOI) was correlated with Mood Disorder Questionnaire(MDQ) bipolarity positive(p=0.033). Conclusions : The present study indicated that possibility of bipolar disorder plays a significant role in suicide attempters. Assessment of suicide ideation severity and possibility of bipolar disorder should be considered when suicide attempters come to emergency room.

Impact of COVID-19-Related Stress and Depression in Public Sector Workers (코로나 19 관련 공공근로자에서의 우울증상 및 스트레스 반응)

  • Park, Jinsol;Cho, Hye-mi;Ko, Min-soo;Chi, Su-hyuk;Han, Changsu;Yi, Hyun-suk;Lee, Moon-Soo
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.136-143
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    • 2021
  • Objectives : The coronavirus disease 2019 (COVID-19) outbreak is a global medical crisis imposing particular burden on public sector employees. The aim of this study was to investigate the psychiatric distress among public sector workers amid the COVID-19 pandemic. Methods : We conducted a cross-sectional study with 531 public sector workers in Gwangmyung city who completed Korean versions of the Perceived Stress Scale (PSS), Patient Health Questionnaire-9 (PHQ-9), and Impact of Event Scale-Revised-Korean (IES-R-K). Results : The results revealed more than moderate levels of stress (85.2%), depressive symptoms (22.2%), and posttraumatic stress symptoms (38.8%). PSS total score was significantly correlated with PHQ-9, IES-R-K total scores as well as IES-R-K subscale scores. Total scores on the PSS, PHQ-9, and IES-R-K were all inversely correlated with age. Conclusions : COVID-19-related workers experience considerable stress and depressive symptoms, with self-rated stress correlating significantly with depression scores. Age may serve as a protective factor against occupational stress and burnout. These findings highlight the need for adequate psychiatric screening and intervention for public sector workers.

The Association Between Cancer and Network Structure of Depressive Symptoms (암과 우울증상 네트워크 구조의 연관성)

  • Hwang, Hwijin;Lee, Kyung Kyu;Lee, Seok Bum;Lee, Jung Jae;Kim, Kyoung Min;Kim, Dohyun
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.121-127
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    • 2021
  • Objectives : The characteristics of depressive symptoms in patients with cancer is different from those in control group. However, few research has focused on the association between depressive symptoms in cancer patients. The aim of this study was to compare the network structure of depressive symptoms between patients with cancer and normal control. Methods : This study was based on cohort data from Korea National Health and Nutrition Examination Survey in 2016-2018. The Patient health Quetionnaire-9 (PHQ-9) was used to assess depressive symptoms in 599 patients with cancer and 599 age-sex matched controls. We estimated network structure of depressive symptom using Isingfit model. Results : There was no significant difference of each PHQ-9 item score. There were strong associations between symptoms were concentration problem-psychomotor activity, anhedonia-depressed mood, and depressed mood-suicidal ideation in both groups. Strength centrality of worthlessness was significantly higher in patients with cancer. Conclusions : These results suggest that worthless is associated with other depressive symptoms more tightly in patients with cancer. Worthless can serve as important treatment targets for intervention of depression in patients with cancer.

Study on the Growth Factors for Rapidly Cultivating Mycobacterium spp. (마이코박테리움을 신속하게 배양할 수 있는 성장 인자에 관한 연구)

  • Ha, Sung-Il;Park, Kang-Gyun;Suk, Hyun-Soo;Shin, Jeong-Seob;Shin, Dong-Pil;Kwon, Min-O;Park, Yeon-Joon
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.177-184
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    • 2019
  • Mycobacteria grow slowly. Therefore, a solid medium should be used for eight weeks and a liquid medium for six weeks. The purpose of this study was to find the growth factors that can grow Mycobacterium rapidly and to help develop a solid medium for rapid identification. Three types of Mycobacterium growth factors were evaluated with 10 Mycobacteria by adding activated charcoal, defibrinated sheep blood, and L-ascorbic acid to $Difco^{TM}$ Mycobacteria 7H11 agar (Becton, Dickinson and Company, Sparks, MD, USA). The time to detection and the distinguishability of a colony were compared with that of the current method. In the rapidly growing Mycobacterium, the difference in detection time between the new media and conventional media confirmed that the new media was faster. M. kansasii and M. intracelluare grew faster in 7H11 C than in 7H11 medium. MTB grew faster than the other media in 7H11 C. This study confirmed that the two growth factors affect fast-growing Mycobacteria and slow-growing Mycobacteria. 7H11 C showed better distinguishability than the conventional media in all 10 Mycobacterium due to the color contrast. In particular, when the MTB was grown, the size of the colonies was larger than with other media, so visualization was easy.

Tumor Recurrence in Hepatocellular Carcinoma Patients after Radiofrequency Ablation: Portal Hypertension as an Indicator of Recurrence of Hepatocellular Carcinoma (간세포암 환자의 고주파열치료 후 종양 재발: 예후인자로서 문맥고혈압)

  • Jang, Seong Won;Cho, Yun Ku;Kim, Ju Won;Gil, Je Ryung;Kim, Mi Young;Lee, Young
    • Journal of the Korean Society of Radiology
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    • v.79 no.5
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    • pp.264-270
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    • 2018
  • Purpose: To evaluate the effect of portal hypertension on the tumor recurrence in patients with hepatocellular carcinoma (HCC) and without hepatic decompression following radiofrequency ablation (RFA). Materials and Methods: Treatment-naïve HCC patients within the Milan criteria and with Child-Pugh class A were included in this study, who had performed RFA in our hospital between January 2010 and March 2017. Univariate and multivariate analyses using the Cox proportional hazard model were performed to find the predictors of local or distant tumor recurrence. Results: Overall, 178 patients were included in this study. Median follow-up period was 40.2 months. The difference in the local tumor progression rates depending on the absence or presence of portal hypertension was not statistically significant (p = 0.195). The 1-, 3-, and 5-year distant intrahepatic tumor spread rates were 6.6%, 29.5%, and 537% in patients without portal hypertension, and 23.4%, 51.9%, and 63.6% in patients with portal hypertension, respectively. The difference was statistically significant (p = 0.011). Univariate and multivariate analysis showed that portal hypertension was an independent predictor for distant intrahepatic tumor spread (p = 0.008). Conclusion: For HCC patients with Child-Pugh class A, portal hypertension adversely affected distant intrahepatic tumor progression.